Clinical features of nephrotic syndrome accompanied by eosinophilia in children / 中国当代儿科杂志

OBJECTIVE@#To study the clinical features of nephrotic syndrome (NS) accompanied by eosinophilia in children.@*METHODS@#A retrospective analysis was performed for the clinical manifestations, laboratory findings and treatment outcomes of 18 cases of eosinophilia (15 children, 3 of whom also had eosinophilia at the second recurrence) in children with NS.@*RESULTS@#Of the 18 cases, 16 (89%) had mild eosinophilia, 1 (6%) had moderate eosinophilia, and 1 (6%) had severe eosinophilia. Twelve cases (67%) developed eosinophilia in winter and spring. Nine cases (50%) had infectious diseases: pneumonia (including 2 cases of Mycoplasma pneumonia) in 4 cases, EB virus infection in 3 cases, suspected pinworm infection in 1 case, and Streptococcal infection in 1 case. Five cases (28%) had allergic diseases: urticaria in 2 cases, allergic rhinitis in 2 cases and eczema in 1 case. There was no significant correlation between eosinophil count and the levels of urinary protein, serum albumin and cholesterol (P>0.05). In 8 cases of newly diagnosed NS, urinary protein turned negative within 4 weeks after glucocorticoid treatment. In 10 cases of recurrent NS, urinary protein turned negative in 9 cases after the adjustment of glucocorticoid treatment. In 1 case of recurrent NS (moderate eosinophilia with allergic rhinitis), symptomatic relief and negative urinary protein were achieved after anti-allergic treatment. Glucocorticoid therapy was not administered again in the patient, and the eosinophil count was reduced to a slight increase. The eosinophil counts of the other 17 cases returned to normal.@*CONCLUSIONS@#NS with eosinophilia in children occurs mostly in winter and spring. This disorder is associated with infection or allergic diseases. There was no significant correlation between eosinophil count and the levels of urinary protein, serum albumin and cholesterol.

Effects of bFGF on brain edema, nerve function injury and autophagy related protein in rats with traumatic brain injury / 中国病理生理杂志

AIM:To study the effects of basic fibroblast growth factor (bFGF) on brain edema, nerve function damage and autophagy related proteins in rats with head injury.METHODS:The rat model of craniocerebral injury (CI) was constructed.The rats were divided into control group, CI group, and low-, middle-and high-dose bFGF groups (n=10).The CI model was established in CI group, while the rats in control group were not given epidural impact.The rats in low-dose, middle-dose and high-dose bFGF groups were given bFGF at 2, 4 and 6μg, respectively, by intraperitoneal injection after 30 min.The neurological function in the rats was evaluated by improved neurological function scoring.The rat brain tissues were taken, and the water content was detected.The levels of tumor necrosis factor-α (TNF-α) , interleukin-6 (IL-6) and IL-1βin the brain tissue were measured by ELISA.The malondialdehyde (MDA) content was analyzed by thiobarbituric acid method.The activity of superoxide dismutase (SOD) was examined by WST-8 assay.The glutathine peroxidase (GSH-Px) activity was detected by colorimetric method.The protein levels of autophagy related proteins LC3-II and beclin-1 in the brain tissues were determined by Western blot.RESULTS:The neurological function score was increased significantly of the rats in CI group.The rat model of craniocerebral injury was successfully constructed.Neurological function scores in the rats in low-dose, middle-dose and high-dose bFGF groups were reduced, the water content of the brain tissue was also reduced (P<0.05).The levels of TNF-α, IL-6 and IL-1βwere decreased in the brain tissues (P<0.05) , the content of MDA was declined (P<0.05) , the activities of SOD and GSH-Px were increased (P<0.05) , the protein levels of LC3-II and beclin-1 were decreased, compared with the untreated rats in CI group (P<0.05).CON-CLUSION:bFGF improves the nerve function of the rats with craniocerebral injury, reduces the water content of the brain tissue, reduces the expression of autophagic protein LC3-II and beclin-1.The mechanism is related to the inhibition of inflammatory reaction and oxidative damage.

Discussion on diagnostic value of urinary neutrophil gelatinase-associated lipocalin in the diagnosis of acute pyelonephritis in children / 天津医药

Objective To explore the diagnostic value of urine neutrophil gelatinase-associated lipocalin (NGAL) in children with acute pyelonephritis. Methods A total of 104 children with urinary tract infection admitted to Tianjin Children's Hospital from December 2016 to May 2017 were selected in this study, including 61 cases with acute pyelonephritis (group APN) and 43 with lower urinary tract infection (group non-APN). The serum levels of beta 2-Microglobulin (β2-MG), cystatin C (CysC), C-reactive protein (CRP), procalcitonin (PCT) and urine levels of NGAL were compared between two groups.Receiver operating characteristic(ROC)curves were drawn to evaluate the diagnostic values of serum β2-MG,CysC,CRP,PCT and urine NGAL.Results The serum levels of CRP,PCT,β2-MG and urinary NGAL were significantly higher in APN group than those in non-APN group (P < 0.05). There was no significant difference in serum CysC level between two groups(P>0.05).The areas under the ROC curve(AUC)for serum CRP,PCT,and urinary NGAL were 0.838,0.898 and 0.963.The optimal cutoff value of serum CRP was 22.6 mg/L,the sensitivity was 75.4% and the specificity was 83.7%. The optimal cutoff value of serum PCT was 0.285 μg/L, the sensitivity was 77.0% and the specificity was 93.0%.The optimal cutoff value of urine NGAL was 473 μg/L,the sensitivity was 82.0% and the specificity was 97.7%.Conclusion Urinary NGAL has high diagnostic value for APN in children,and which is helpful for the early identification of APN.

Spectrum and drug sensitivity of pathogenic bacteria in children with nephrotic syndrome complicated by urinary tract infection: an analysis of 97 cases / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the spectrum and drug sensitivity of pathogenic bacteria in children with nephrotic syndrome (NS) complicated by urinary tract infection (UTI).</p><p><b>METHODS</b>A retrospective analysis was performed on the spectrum and drug sensitivity of pathogenic bacteria in 97 children with NS complicated by UTI, who hospitalized from January to December, 2011.</p><p><b>RESULTS</b>The incidence of UTI in children with NS was 36.5%. It was significantly more common in children with recurrent NS than in those with primary NS (44.0% vs 31.9%; P<0.05). These cases mainly presented with asymptomatic bacteriuria. Enterococcus was the most common pathogenic bacteria (50.5%), including Enterococcus faecium (29.4%) and Enterococcus faecalis (21.1%), followed by Gram-negative bacteria, such as Escherichia coli (15.6%) and Klebsiella pneumoniae (14.7%). Enterococcus was highly sensitive to nitrofurantoin, vacomycin and linezolid, but was highly resistant to tetracycline and moxifloxacin. More multi-resistant strains were detected in Enterococcus faecium than in Enterococcus faecalis (72% vs 17%; P<0.05). Escherichia coli and Klebsiella pneumoniae were highly sensitive to amikacin, imipenem and piperacillin/tazobactam. Of the Gram-negative bacteria, 25% produced extended spectrum β-lactamases (ESBLs). ESBLs-producing bacteria had 100% sensitivity to imipenem, amikacin and piperacillin/tazobactam but were highly resistant to ampicillin, cefazolin and ceftriaxone.</p><p><b>CONCLUSIONS</b>Children with recurrent NS are more susceptible to UTI than those with primary NS. Enterococcus is becoming major pathogenic bacteria for UTI in children with NS and has relatively high drug resistance, and most strains of Enterococcus faecium are multi-resistant.</p>

Antibiotic resistance of pathogens isolated from 181 children with complicated urinary tract infection / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To investigate the distribution and antibiotic resistance of pathogens isolated from children with complicated urinary tract infection.</p><p><b>METHODS</b>A retrospective analysis was performed on the distribution and antibiotic resistance of pathogens isolated from 181 children with complicated urinary tract infection (positive urine culture). The antibiotic resistance of common pathogens was determined by the antimicrobial susceptibility test.</p><p><b>RESULTS</b>Gram-negative bacilli were the main pathogens (63.5%), and involved Escherichia coli (E.coli) of 42.0%. Gram-positive cocci accounted for 32.1%, and involved enterococci faecalis of 15.5%. Fungi infection was found in 4.4% of children. The resistance rate of E.coli to ampicillin was the highest (89.4%), but the rate decreased significantly by adding amoxicillin/clavulanic acid (34.2%). E.coli had a high resistance rate to cephazolin, ceftriaxone and cafalotin (>50%), but the resistance rate of E.coli to cefoperazone/sulbouam was significantly lower than other cephalosporins (P<0.01). E.coli was sensitive to imipenem and displayed a lower resistance rate to furadantin (<10%). The resistance rate of enterococci faecalis to rifampicin was high (78.3%), but was low to furadantin, vancomycin and linezolid (<10%). The multiresistant strains accounted for 77.4% of gram-negative bacilli.</p><p><b>CONCLUSIONS</b>E.coli is the major pathogen in children with complicated urinary tract infection, and the enterococci-caused urinary tract infection has been increasing. These pathogens have a high antibiotic resistance, and most of them are multiresistant. Antimicrobial therapy should be based on the results of urine culture and antimicrobial susceptibility test.</p>

Clinical research of vestibular autorotation test for patients with vertebrobasilar insufficiency / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the diagnostic values of vestibular autorotation test (VAT) for patients with vertebrobasilar insufficiency (VBI).</p><p><b>METHODS</b>VAT and videonystagmography ( VNG) were performed on 73 patients with VBI and 48 patients with peripheral vestibular lesions (contrast group). Parameters analyzed included Gain, phase and asymmetry of VAT, as well as the canal paresis (CP) of caloric test and results of optokinetic-pursuit tests in VNG. Positive result of the test could be defined if anyone of the parameters was abnormal.</p><p><b>RESULTS</b>For VAT test, Gain was enhanced in VBI group and was reduced in contrast group. In VBI group and contrast group, Gain enhanced showed in 47 (64.4%) cases and 5 (10.4%) cases, respectively (chi2 = 31.19, P < 0.01). Simultaneity, Gain reduced in 11 cases (15.5%) and 22 cases (45.8%), respectively (chi2 = 13.82, P < 0.01). But there was no statistics significant for results of the parameters of phase, asymmetry and integration between two groups. For VNG test, results with optokinetic-pursuit tests were more abnormal in VBI group than that in contrast group, which showed central lesions characteristics. Forty-four cases (60.3%) in VBI group and 10 cases (20.8%) in control group showed central lesions results with optokinetic-pursuit tests and visual fixation test (chi2 = 15.89, P < 0.01). Unilateral or bilateral CP showed in 33 cases (68.6%) in control group and 51 cases (69.9%) in VBI group with caloric test.</p><p><b>CONCLUSIONS</b>Gain of VAT is mostly enhanced in VBI group, and Gain as a main characteristic is reduced in patients with peripheral vestibular lesions. The Gain parameter is availability for assessing characteristics of vestibular lesions. Phase and asymmetry can be used to assess the vestibular function but can not indicate the characteristics of vestibular lesions.</p>

Bacterial pathogens and resistance patterns in community acquired pediatric urinary tract infection: experience of 152 cases / 中国当代儿科杂志

<p><b>OBJECTIVE</b>This study investigated the pathogen distribution and resistance patterns in childhood urinary tract infection in order to provide references for optimal use of antibiotics in the treatment of this disorder.</p><p><b>METHODS</b>The clinical data of 152 children with community acquired urinary tract infection (urinary culture positive) between December 2001 and December 2004 were studied retrospectively. The bacterial pathogens of urinary tract infection and antimicrobial resistance were analyzed.</p><p><b>RESULTS</b>Gram-negative bacilli was predominant pathogenic bacteria, accounting for 79.0% of the cases, and Escherichia coli (E. coli) was most commonly found (56.2%). Gram-positive cocci accounted for 18.4%, including 15.1% of Enterococcus faecalis. Fungi was rarely seen, accounting for only 2.6%. E. coli had a resistance rate of more than 50% to ampicillin, amoxicillin/clavulate, co-trimoxazole, cefradine, and fosomycin, but a very low resistance rate (< 4%) to 3rd generation cefalosporin, nitrofurantoi, azactom and amikacin. Enterococcus faecalis had a low resistance rate (< 20%) to ampicillin, vancomycin, penicillin, and nitrofurantoin.</p><p><b>CONCLUSIONS</b>E. coli is the major pathogen in community acquired pediatric urinary tract infection, and Enterococcus has been become another important pathogen. Selection of antibiotics for the treatment of this disorder should base on drug-sensitive test results.</p>

Craniofacial characteristics of the Class II division 1 malocclusion patients with mouth-breating: a posteroanterior / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To evaluate the craniofacial characteristics of the Class II malocclusion patients with mouth-breating by posteroanterior cephalometry.</p><p><b>METHODS</b>To measure craniofacial width of the 12 Class II malocclusion patients with mouth-breathing, and to compared these measures with corresponding measures in a group of normal children.</p><p><b>RESULTS</b>The width of the maxillary base bone (J-J) was less than that in normal children significantly (P < 0.01). The mouth-breathing children's upper and lower arch width (at first molar and cuspid) were comparatively narrower, and lateronasal width (Lap-Lap) was narrower too.</p><p><b>CONCLUSION</b>Mouth breathing may lead to craniofacial morphological abnormal development in craniofacial transverse structures.</p>

Significance of Detection of CD4~+ CD_(25)~(high) Regulatory T Cells in Children with Juvenile Idiopathic Arthritis / 实用儿科临床杂志

Objective To investigate the potential role of CD4+CD25high in the generation of juvenile idiopathic arthritis(JIA).Methods Expression of CD4 and CD25 on T cells in peripheral blood and synovial fluid were examined by flow cytometry,and the FoxP3 expression was detected through intracellular staining.Peripheral blood from 7 healthy children matched in age and gender served as normal control.Results Compared with normal control,there were increased number of CD4+CD25high T cell in JIA synovial fluid which expressed high level FoxP3,but decreased number in peripheral blood.Conclusion Accumulation of natural regulatory T cells in local tissue of JIA may contribute to the pathological process of such disease.